MCQS

Antenatal care - Multiple choice questions: set 5

Devender Roberts James P Neilson

MBChB MRCOG BSc MD FRCOG
True False True False
A Iron supplementation in pregnancy D In implementing Anti-D prophylaxis of
1 The fall in haemoglobin concentration and RhD negative women in pregnancy, which of
haematocrit in pregnancy results from differential
changes in red cell mass and plasma volume. c 'I
the following statements are correct?
1 When no red cell antibodies are detected at booking.
2 Ferrous gluconate causes fewer gastrointestinal all women should he re-tested once a month. 3 '~Y
complications than ferrous sulphate. E U
3 The haematological response to parenteral iron
2 All women should he given Anti-D IgG and have a
Kleihauer test following a potentially sensitising event.
'7 r1 ~'

is no better than with ordl iron. [; r~l

i~
.~

3 The use of Anti-L) has prevented all pregnant RhD

4 In healthy, well fed women, routine iron
supplementation has beneficial effects o n the
outcome of pregnancy. 3 c
5 Women with a high level of hdemoglobin in pregnancy P
have less tendency t o postpartum haemorrhage.
B With regard to urine testing as a routine
part of antenatal care, which of the following
statements are correct?
1 A single episode of glycosiiria warrants a glucose
tolerance test. rl 7
2 Glycosuria and proteinuria can both be associated
with urinary tract infections. n 1'
3 Twenty-five to 30% of \yomen with asymptoniatic
bacteriuria will develop asymptomatic urinary tract
infection while pregnant. r! 2
4 The sensitivity of reagent strips is sufficient for them
to t)e used in screening for asymptomatic hacteriuria.
5 Significant proteinuria can only h e assessed by
3 7
performing a 24 hour urinary protein measurement.
negative Lvonien from developing anti-D antibodies. c;c
4 A 500 iu dose of Anti-1) is sufficient t o cover ;I
feto-maternal haemorrhage of 4 mls of red blood
r cells (i.e. 125 iiidml haemorrhage). 7 3
5 Antenatal prophylaxis of RhL) immunisation ivith
250-300 iu Anti-D at 28 aeeks gestation will
significantly reduce the nuinher of women nho
become sensitised. 1 1 _1
E A primigravida presents at 32 weeks
gestation with a symphysis-fundalheight
measuring 28 cm
1 Symphysis-fiindal height measurement is a n
accurate method of detec,ting fetal grcnvtli
retardation. I , '7
2 Abdominal circumference is the single best ultrasound
predictor o f the sinall for gestational age fetus. '-I-
3 Cardiotocography can he used in the assessment
L-I T
of the growth-retarded fetus. L A

C A 39 year old primigravida has a fetal Down 4 Doppler ultrasound in high risk pregnancies is
syndrome risk of 1 5 0 following antenatal associated with a 30% reduction in perinatal mortality. I
1

~ ~
8

5
serum testing at 16 weeks gestation 5 Reduced amniotic fluid volume is associated Lvith
1 The age-related risk at 39 years is sufficiently high to
increased perinatal morbidity and mortality.
'
:~-A
I
rr,
warrant offering a primary invasive test as an option. 0
AUTHOR DETAILS
2 Second triinester ultrasound will identify all
pregnancies affected by Down syndrome. C Dr Devender Roberts M f K ~ h H MIICOG. Ixctiirer, I'niversity
llcpartment o f Ohstetric~ c9 Gynaecology. Liverpool Wonlen's
3 Screening based solely on the basis of EIospital. Crown Street. I.ivt.rpod 1.18 11.". I' K
amniocentesis for all women above the age of 35 years Professor James P Neilsen HSc $11) FIICO(;. I Inrvcrsitp 1)ep;rrtmenl
detects 50% of Down-affected pregnancies. El 01 Obsletrics c9 Gpnaecology, Liverpool Women's Hospital,
4 First trimester nuchal translucency screening in 1,iverpool.CK
combination with maternal age has high detection Correspondence to: I l r Devcncler Roberts
rates for aneuploidy and may also detect
pregnancies that are destined to miscarry. ri If you intend to claim CME credits, transfer your
5 Free P-hCG and PAPP-A are the two most answers to the enclosed CME answer sheet and
potent serum markers in the first trimester. L return it to the CME office at the College.

40 The Obstetrician G Gynaecologisl July 19% Vol. I No. I